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Letter For C & P States I Can't Bring Records To Exam!



Got my packet for a C & P exam with a doctor contracted by the VA as arranged by a company called QTC Medical Services.

I have posted a few times about this and don’t want to come across as redundant, but this pre-exam packet, I believed is weighed against me.

I want to provide this general medicine doctor (not a specialist) with my relevant medical evidence. Especially the data from the VA doctor and three civilian podiatrists’. The packet states that I CAN’T bring any info with me and I must submit data directly to the VA.

I am already granted a partial award for feet problems and I just can’t believe that they are sending me to a contracted doctor, especially since I have access to a major VA hospital and the VA Dr noted all of my issues in the record!

Someone told me that they are trying to give me the run around so that I just drop my claim. I don’t know if that is true, but this will be my 2nd C & P for the same issue!

It is interesting that the packet had a print out from Mapquest with directions from my place to the doctors office!! That has neverhappened before.

Does anyone know hoe I would get a copy of this type of exam? The packet states that I CAN”T get any info / results from the doctor!!!!


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  • HadIt.com Elder

Sounds like a Federal OWCP trick........farming out C&P's. Anything you have that has been included in your C-file or date stamped as received by the VA TAKE IT.

Make sure it is looked at, and refrenced in your C&P exam results, if not then I would file a complaint with the VA.......you may want to contact your POA on this, as it is the first time I have heard of the VA contracting out C&P's.

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If you have relevant information regarding your upcoming C&P claim SUBMIT it, especially if it's gonna benefit your claim. If you have additional information submit it regardless of the fact that the VA has contracted doctors. I am rated 100% P/T and never took any records with me to an exam. The examiner was provided my medical records from the VA, so why would I need to take records from a VA doc? Any other records that you have should be provided to the VA by YOU. During my exams the Doc would make reference to any previous notes or visit that he had right there and I would confirm his observations. Yes, mention it to the C&P examiner about any other opinions by other doctors, but don't drive yourself "nuts" over that as long as the facts are there you will prevail. Perhaps you may consider, if you don't already have, getting a POA. Hope this helps and good luck. If anything I've said in error please forgive.


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  • HadIt.com Elder

The VA contracts out their C&P's, almost ALL their C&P's.

I just had three this week, as a matter-of-fact.

One psych exam was done by a Clinical Psychologist who is employed by the VA.

One gastro, carried out by a PA, under contract, at X number of dollars per C&P exam.

One by an ortho PA, also on a contract basis, same as the gastro PA.

All of these C&P's were carried out at the Dallas VAMC ( a fairly large VA hospital ), not at an off-site clinic somewhere in the boonies.

All three went well, I do believe.

I will know when I get my med records from the FOIA office, which is located at the VAMC.

This is how YOU would go about getting a copy of YOUR C&P's, regardless of whether a VA employee did the exam, or whether it was contracted out to a non-VA employee.

Any medical exam, treatment, x-rays, lab reports, etc., will be located at the VA hospital that you have designated as the location of your choice for hospital treatment. If the treatment, etc., was conducted at an off-site clinic established and ran by the VA area hospital, then the records will be located at both the clinic AND the VA hospital, BUT, you will be able to get copies ONLY through the FOIA (Freedom Of Information Act) medical records office at the HOSPITAL.

You can either do this in person (much the best way to do it) or by written request (you used to be able to do it over the telephone but, as I am hearing now, the HIPPA privacy act is causing some places to NOT release ANY medical records unless specifically requested by the person whose records they are, and then, only IN person.

If you DO NOT have a full and complete copy of ALL your VA med recs, get them. Then LOOK at them. READ them. Had a friend of mine, read his, didn't realize he had had a sex change operation (just joking) until he read his med rec copies, in which some of them referred to him as Billie (she) as opposed to Billy (he), to the point of referring to him as her, etc.

Usually takes the FOIA med records office just a couple of minutes to print you out your copies while you stand there and make small talk with the clerk. No problema. Take your VA ID card with you.

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  • HadIt.com Elder

BTW, if your info for your C&P is NOT in your C-file, do NOT waste your time dragging a bunch of stuff to your C&P exam. Doesn't matter WHAT you have, if it's NOT in your C&P file.....fergitaboutit. If you haven't submitted your stuff through the VARO and they haven't vetted it and included it in your C-file, then whatever it is that you want included for your VA examiner to see and read....well, it's just too late.

Reason being, is the fact that they will not (and, unfortunately, cannot) trust you and whatever unsubstantiated paper work that you might have.

Do not bother them with it. It'll just be a distraction and could, possibly, irritate the examiner (read: probably WILL irritate the examiner). They just have a certain alloted amount of time to see you (and the other 15-20 people that they have to examine today).

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  • HadIt.com Elder




VA guidelines MANDATE a review of the Claims-File prior to a Compensation and Pension Examination.

This is just one more example of the VA refusing to follow it's own rules and regulations! I could scream, really.

Make a copy (for yourself) of the pertinent Exam Worksheet http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Study it, create a checklist, write your questions and answers on index cards, etc., and go into the C&P armed with knowledge -- make sure he does his job examining you.

Maintain your military bearing -- and do not minimize your problems.

Edited by Wings
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"Does anyone know hoe I would get a copy of this type of exam? The packet states that I CAN”T get any info / results from the doctor!!!!"

You can request a copy of the C & P exam results from the Records access officer at the VAMC where it occurs.

Dont forget to put your c file # on the request.

I agree with others here-

make sure the RO has this info -

these C & P docs wont take the time to read it-but I also say bring it anyhow-

just in case you have an opportunity to show it to the doctor.

But it should be in the c file already however for the doctor to see.

Have you sent it to the RO already so it appears in the c file if you can't present it?

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Thanks everyone for the advice. Yes I have submitted all of the med evidence which is what the VA used for my initial rating. I then submitted new and material evidence for a recon and thta evidence was fool proof, but for some reason they are still making go to another C & P.


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  • HadIt.com Elder

I then submitted new and material evidence for a recon and thta evidence was fool proof, but for some reason they are still making go to another C & P.

That is why you are getting another C&P......new evidence not previously considerd.

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You wrote "That is why you are getting another C&P......new evidence not previously considerd."

If your new evidence is suitable for rating (like a well written IMO) then why would they need another C&P exam? It would make VA sense if the new evidence refutes some other evidence (like an initial C&P exam) that they would want to order another C&P exam to see which side all the evidence falls out on rather than just accept your favorable evidence and award under benefit of doubt since the evidence would be in equipose. I'm not saying it's right that they'd order another C&P exam rather than rate under benefit of doubt I'm just saying I understand that's what the VA does.

But in the case of new favorable evidence that is unrefutted in the file I would think the Mariano case Berta told us all about would be the governing rule (see Berta's previous "Unrebutted Medical Evidence" post) and they should just accept the new evidence and rate on it if it's unrefutted in the claims file. Or am I being naive here?



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What is the date of your LAST (or first) C&P exam?

It was in 2005 by a VA PA, not a foot doctor, needless to say, he basically said my feet were bad and aggreverated due to Mil Ser.

Since then, I got into the VA Med system and saw a VA Ft Dr who basically said 100% my feet issues are Mil related. So they first approved SC at 0% then I NODed it which resulted in 30%.

Why do I have to see a non foot dr outside the VA when I have so much evidence?

It's not like you can fake flat feet with hammer toes, bunions, corns, skin problems, missing and disclored toe nails and about 8 other thing the VA and civilian Dr's diagonsed. I have all of the evidence.

I guess I am shocked that the VA would send me to a cilivian Dr (who is not a podiatrist) when I LIVE near a VAMC and 3 three civilian and 1 VA Ft Dr have agreed on the serious nature of my feet. I am alos suprised that this is being disputed by the VARO

What could be their motive?

In their standard form letter to me, they state that my SC "AWARD" could be increased, stay the same or DECREASE!! All the Ft Dr's (VA & Civilian) state that the surgery would take 6 months recovery for each foot which is a full year I would be off my feet!


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  • HadIt.com Elder

I would be careful about foot surgery. Even minor procedures can really put you off your feet or hurt for months afterward. I had a non-invasive procedure done on my right foot and it was supposed to heal in 3 months. 6 months later I was still limping. All I wanted was for it to hurt like it used to hurt before the procedure. I would not let some VA surgeon ever do anything with my feet.

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  • HadIt.com Elder




Date: February 2, 1994 O.G.C. Precedent 2-94

From: General Counsel (022)

Subj: Special Monthly Compensation Under 38 U.S.C. § 1114(s)

To: Chairman, Board of Veterans' Appeals (01)


Does a temporary total rating based on convalescence, under 38 C.F.R. § 4.30, satisfy the requirement in 38 U.S.C. § 1114(s) of a disability rated as total for entitlement to special monthly compensation?


1. Section 1114(s) of title 38, United States Code, provides a special rate of wartime disability compensation for veterans who have "a service-connected disability rated as total" and meet other criteria not relevant to the present inquiry. (Section 1134 of title 38, United States Code, provides that the same rates of compensation shall be paid for peacetime disability.) Public L. No. 86-663, 74 Stat. 528 (1960), added subsection (s) to what is now section 1114. The statutory requirement for "a service-connected disability rated as total" has remained the same in that section since that time.

2. Section 4.30 of title 38, Code of Federal Regulations, entitled "Convalescent ratings," provides a total disability rating without regard to other provisions of the rating schedule when treatment of a service-connected disability results in surgery necessitating at least one month of convalescence, surgery with severe postoperative residuals, or immobilization by cast, without surgery, of one major joint or more. The duration of these ratings is limited to a maximum of twelve months beyond the period of hospitalization or outpatient treatment during which the qualifying treatment occurred. See 38 C.F.R. § 4.30. VA extended the Schedule for Rating Disabilities to authorize such temporary total ratings, then called temporary surgical ratings, in 1950. Extension 7, Veterans Administration Schedule for Rating Disabilities (1945 ed.) (July 6, 1950). Thus, we may presume that Congress knew that temporary total ratings existed when it enacted Pub. L. No. 86-663 in 1960. Ranes v. Office Employees Int'l Union Local 28, 317 F.2d 915, 918 (7th Cir. 1963).

3. Shortly after enactment of Pub. L. No. 86-663, the Administrator of the Veterans Administration issued Instruction 1 "to implement the provisions of Public L[. No.] 86-663, pending revision of pertinent VA regulations and procedural manuals." In that instruction, the Administrator interpreted the phrase "a service-connected disability rated as total" to mean "a single disability rated 100 percent under regular schedular evaluations without employment of exceptional provisions for temporary application as in paragraphs 28, 29, and 30 . . . [of the] 1945 Schedule for Rating Disabilities." Instruction 1, Pub. L. No. 86-663, para. 3(a)(1) (Sept. 30, 1960). Shortly after the Administrator issued that instruction, the General Counsel said that this interpretation accorded with previously expressed views of the General Counsel that:

the temporary ratings authorized by these paragraphs do not constitute regular schedular ratings in the ordinary sense but rather the granting of a monetary benefit for a specified period of hospitalization or convalescence, at the expiration of which the veterans concerned revert to the ratings to which their disabilities entitle them under the 1945 Schedule of Disability Ratings. Memorandum to Chief Benefits Director, on Interpretation of Pub. L. No. 86-663 (Jan. 25, 1961).

4. VA incorporated this interpretation into its regulation implementing Pub. L. No. 86-663, codified at 38 C.F.R. § 3.350(i), by providing that "the special monthly compensation . . . provided by 38 U.S.C. § [1114](s) is payable where the veteran has a single service-connected disability rated as 100 percent under regular schedular evaluation and" meets other criteria. 27 Fed. Reg. 4739 (1962) (emphasis added).

5. In 1973, VA changed the language of the regulation to provide that the special monthly compensation is payable to veterans with "a single service-connected disability rated as 100 percent without resort to individual unemployability" and who meet the other criteria. 38 Fed. Reg. 20,831, 20,832 (1973) (emphasis added). Although VA intended this change in regulatory language as a liberalization, it did not thereby intend to make section-1114(s) special monthly compensation payable to veterans with a single service-connected disability rated as total under the provisions of 38 C.F.R. § 4.28, 4.29, or 4.30. The change was "to provide a liberalization applicable to those who have a service-connected disability evaluated at 100 percent . . . pursuant to the 'extra schedular' provisions of [38 C.F.R.] § 3.321(b)." 38 Fed. Reg. at 20,832. Hence, the VBA manual provides that ratings of 100 percent under 38 C.F.R. § 4.30 may not serve as a basis for entitlement to section-1114(s) special monthly compensation. VBA Manual, M21-1, part VI, para. 8.06 (Sept. 21, 1992).

6. The first step in determining whether VA's interpretation of section 1114(s), as codified in 38 C.F.R. § 3.350(i), is inconsistent with the statute is to determine the meaning of the statute. We are not aware of any case in which the United States Court of Veterans Appeals (CVA) has interpreted the language of section 1114(s) in question. Since there appears to be no pertinent case law, we must interpret the statute ourselves. "The starting point in interpreting a statute is its language, for 'f the intent of Congress is clear, that is the end of the matter.'" Good Samaritan Hosp. v. Shalala, 113 S. Ct. 2151, 2157 (1993) (quoting Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 842 (1984)). The meaning of a statute must, in the first instance, be sought in the language in which the act is framed. Caminetti v. United States, 242 U.S. 470, 485 (1917). If the language is plain and does not lead to absurd or wholly impracticable consequences, it is the sole evidence of the ultimate legislative intent. Id. at 490. In our opinion, the language of section 1114(s) is plain and unambiguous. It requires "a service-connected disability rated as total." It means a service-connected disability assigned a rating such that compensation is payable at the rate authorized in 38 U.S.C. § 1114(j). Even VA's regulation on "[t]otal disability ratings," 38 C.F.R. § 4.15, provides no narrower meaning for a total rating.

7. We find nothing in the language of section 1114(s) to indicate that Congress meant to exclude service-connected disabilities rated as total under 38 C.F.R. § 4.28, 4.29, or 4.30. (Although it is not the question before us, we also find nothing in the language of section 1114(s) to indicate that Congress meant to exclude service-connected disabilities rated as total under 38 C.F.R. § 4.16, i.e., a total rating based on individual unemployability.) Where statutory language does not establish a condition to its application, such a condition may not be construed unless a straightforward application of the language as written would violate or affect the clear purpose of the enactment. Dameron v. Brodhead, 345 U.S. 322, 326 (1953) (citations omitted). The clear purpose of Pub. L. No. 86-663 was to create a rate of compensation intermediate to the rates for veterans so disabled as to warrant a higher rate of special monthly compensation under 38 U.S.C. § 1114 (such as for the permanently bedridden or those needing the regular aid and attendance of another person) and veterans with a total disability who nevertheless can supplement their disability compensation by working. S. Rep. No. 1745, 86th Cong., 2d Sess. 2 (1960), reprinted in 1960 U.S.C.C.A.N. 3197, 3198. Congress did not manifestly restrict the applicability of section 1114(s) to total ratings of indefinite duration, and the application of section 1114(s) to temporary total ratings would not violate the clear purpose of Pub. L. No. 86-663. Accordingly, VA may not impose its own restrictions on the applicability of section 1114(s). In our view, it is likely that the CVA would invalidate 38 C.F.R. § 3.350(i) on these grounds in an appeal in which its validity was at issue.

8. Although the General Counsel in 1961 opined that VA's interpretation of Pub. L. No. 86-663 accorded with the General Counsel's views with regard to the nature of temporary total ratings, we do not find the nature of temporary total ratings a persuasive reason for excluding them from consideration under section 1114(s). The temporary total ratings authorized by 38 C.F.R. § 4.28, 4.29, and 4.30 may well not be regular schedular ratings in the ordinary sense, but the General Counsel gave no reason for the belief that Congress intended to exclude those ratings from consideration under section 1114(s). Given that the plain and unambiguous language in which Congress expressed its intent manifests no exclusion based on the nature of certain total ratings, we conclude that there is no such exclusion.


The plain and unambiguous language of 38 U.S.C. § 1114(s) does not restrict the nature of total ratings that may serve as a basis of entitlement to the special rate of disability compensation which section 1114(s) authorizes. A temporary total rating based on convalescence, under 38 C.F.R. § 4.30, satisfies the requirement in section 1114(s) of a disability rated as total.

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